The endogenous hormone AngII is a linear octapeptide (Asp1-Arg2-Val3-Tyr4-Ile5-His6-Pro7-Phe8), and is the active component of the renin-angiotensin system (RAS). It is produced by the sequential processing of the pro-hormone angiotensinogen by renin and angiotensin converting enzyme (ACE).
The renin-angiotensin system (RAS) plays an important role in the regulation of blood pressure, body fluid and electrolyte homeostasis. Ang II exerts these physiological actions in many organs including the kidneys, the adrenal glands, the heart, blood vessels, the brain, the gastrointestinal tract and the reproductive organs (de Gasparo et al, Pharmacol. Rev. (2000) 52, 415-472).
Two main classes of AngII receptors have been identified, and designated as the type 1 receptor (hereinafter the AT1 receptor) and the AT2 receptor. The AT1 receptor is expressed in most organs, and is believed to be responsible for the majority of the biological effects of AngII. The AT2 receptor is more prevalent than the AT1 receptor in fetal tissues, the adult ovaries, the adrenal medulla and the pancreas. An equal distribution is reported in the brain and uterus (Ardaillou, J. Am. Soc. Nephrol., 10, S30-39 (1999)).
Several studies in adult individuals appear to demonstrate that, in the modulation of the response following AngII stimulation, activation of the AT2 receptor has opposing effects to those mediated by the AT1 receptor.
The AT2 receptor has also been shown to be involved in apoptosis and inhibition of cell proliferation (see de Gasparo et al, supra). Further, it seems to play a role in blood pressure control. For example, it has been shown in transgenic mice lacking AT2 receptors that their blood pressure was elevated. Furthermore, it has been concluded that the AT2 receptor is involved in exploratory behaviour, pain sensitivity and thermoregulation.
The expression of AT2 receptors has also been shown to increase during pathological circumstances, such as vascular injury, wound healing and heart failure (see de Gasparo et al, supra).
The expected pharmacological effects of agonism of the AT2 receptor are described generally in de Gasparo et al, supra.
More recently, AT2 receptor agonists have been shown to be of potential utility in the treatment and/or prophylaxis of disorders of the alimentary tract, such as dyspepsia and irritable bowel syndrome, as well as multiple organ failure (see international patent application WO 99/43339).
AngII antagonists (which bind to the AT1 and/or AT2 receptors) have been disclosed in inter alia international applications WO 93/04045, WO 93/04046, WO 94/11379 and WO 94/28896, U.S. Pat. Nos. 5,312,820 and 5,512,681, European patent applications EP 0 499 415, EP 399 731 and EP 399 732, Pandya et al, Bioorganic & Medicinal Chemistry, 9, 291-300 (2001) and Chang et al, Bioorganic & Medicinal Chemistry Letters, 4, 2787-2792 (1994). The use of the compounds disclosed in these documents as agonists of AngII, and in particular the AT2 receptor, is not contemplated.
U.S. Pat. No. 5,444,067 discloses compounds comprising an imidazolyl group attached, via a methylene bridge, to a phenylthiophene moiety, as AngII agonists. The phenyl ring of the phenylthiophene moiety in these molecules is 1,4-disubstituted with the thiophene and the imidazolyl group (which is attached via a methylene bridge).
More recently, international patent applications WO 02/96883, WO 03/064414, WO 2004/085420, WO 2004/046128, WO 2004/046141 and WO 2004/046137 have disclosed various multicyclic compounds as agonists of AngII and in particular as selective AT2 receptor agonists. In the compounds disclosed in these documents, a central aryl ring is disubstituted in the 1,4 (para) configuration. None of these documents mention or suggest compounds in which such an aryl group is disubstituted in the 1,3 (meta) configuration.
We have now found that such compounds are effective and/or selective AT2 receptor agonists and are therefore expected to find utility in inter alia the above-mentioned conditions.